Chou Meng-Shih, Chang Wen-Dien, Lin Che-Chen, Li Yu-Fen, Tsou Yung-An
Department of Otolaryngology-Head and Neck Surgery Department of Sports Medicine Management Office for Health Data Department of Public Health Institute of Biostatistics Graduate Institute of Clinical Medical Science Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan.
Medicine (Baltimore). 2017 Aug;96(31):e7586. doi: 10.1097/MD.0000000000007586.
Sleep-disordered breathing (SDB) and Eustachian tube disorders (ETDs) share the same risk factors. The specific aim of this study was to determine the correlation between these 2 conditions and to determine whether treatments for SDB reduce the risk of ETD.This is a retrospective and large population-based cohort study. According to Taiwan's National Health Insurance Research Database, out of 1,000,000 insured patients, 24,251 patients were newly diagnosed with SDB from year 2000 through 2009. The control group for this study comprised 96,827 patients without SDB who were randomly selected from the same database at a ratio of 1:4, frequency matched for sex, age, and index year of SDB. The incidence of developing ETD was compared between these 2 groups; the main covariates were demographic data, interventions, and medical comorbidities.There was an increased risk of developing ETD among the SDB cohort compared with the control group (hazard ratio = 1.51, 95% confidence interval = 1.41-1.63). Compared with SDB patients who did not receive treatment, those who received the treatment, that is, pharyngeal or nasal surgery, CPAP, or multiple modalities (both surgery and CPAP), had a significantly reduced risk of developing ETD.This study showed that patients with SDB are at an increased risk of developing ETD and other comorbidities. The risk of developing ETD can be reduced by implementing prompt treatment for SDB. Multidisciplinary evaluation including ETD should be conducted in the management of patients presenting with SDB.
睡眠呼吸障碍（SDB）和咽鼓管疾病（ETD）具有相同的风险因素。本研究的具体目的是确定这两种疾病之间的相关性，并确定SDB的治疗是否能降低ETD的风险。这是一项基于大人群的回顾性队列研究。根据台湾国民健康保险研究数据库，在100万参保患者中，有24251名患者在2000年至2009年期间新诊断为SDB。本研究的对照组由96827名无SDB的患者组成，他们是从同一数据库中以1:4的比例随机选取的，在性别、年龄和SDB的索引年份上进行频率匹配。比较了这两组中发生ETD的发生率；主要协变量为人口统计学数据、干预措施和合并症。与对照组相比，SDB队列中发生ETD的风险增加（风险比=1.51，95%置信区间=1.41-1.63）。与未接受治疗的SDB患者相比，接受治疗（即咽或鼻手术、持续气道正压通气（CPAP）或多种方式（手术和CPAP））的患者发生ETD的风险显著降低。本研究表明，SDB患者发生ETD和其他合并症的风险增加。通过对SDB进行及时治疗可以降低发生ETD的风险。在管理患有SDB的患者时，应进行包括ETD在内的多学科评估。
